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Öğe Altered cardiac autonomic function after recovery from COVID-19(Wiley, 2022) Kurtoglu, Ertugrul; Afsin, Abdulmecit; Aktas, Ibrahim; Akturk, Erdal; Kutlusoy, Ergun; Cagasar, OzlemBackground Autonomic dysfunction may occur during the acute phase of COVID-19. Heart rate variability (HRV) is a useful tool for the assessment of cardiac sympathetic and parasympathetic balance. We aimed to evaluate cardiac autonomic function by using HRV in subjects after recovery from COVID-19 who had previously symptomatic and were followed outpatiently. Methods The study group composed of 50 subjects with a confirmed history of COVID-19 and the control group composed of 50 healthy subjects without a history of COVID-19 and vaccination. All the study participants underwent 2-dimensional, pulsed- and tissue-Doppler echocardiographic examinations and 24-hour Holter monitoring for HRV analysis. Results Time domain parameters of SDNN, SDANN, SDNNi, RMSSD, pNN50, and HRV triangular index were all decreased in the study group when compared with the control group. Frequency domain parameters of TP, VLF, LF, HF, and HFnu were also decreased in the study group in comparison with the control group. LFnu was similar between groups. Nonlinear parameters of HRV including alpha(1) and alpha(2) decreased in the study group. By contrast, Lmax, Lmean, DET, REC, and Shannon entropy increased in the study population. Approximate and sample entropies also enhanced in the study group. Conclusions The present study showed that all three domain HRV significantly altered in patients after recovery from COVID-19 indicating some degree of dysfunction in cardiac autonomic nervous system. HRV may be a useful tool for the detection of preclinical autonomic dysfunction in this group of patients.Öğe Assessment of atrial conduction time by tissue Doppler echocardiography and P-wave dispersion in patients with mitral annulus calcification(Churchill Livingstone Inc Medical Publishers, 2010) Pekdemir, Hasan; Cansel, Mehmet; Yagmur, Julide; Acikgoz, Nusret; Ermis, Necip; Kurtoglu, Ertugrul; Tasolar, HakanThe aim of our study was to investigate atrial conduction time in patients with mitral annulus calcification (MAC) using P-wave dispersion (PWD) and electromechanical coupling measured with the surface electrocardiogram and the tissue Doppler echocardiography. Fifty-nine patients with MAC and 43 control subjects underwent resting the surface electrocardiogram and tissue Doppler echocardiography. The difference between the maximum (Pmax) and minimum P-wave durations was calculated and defined as PWD. Interatrial and intraatrial electromechanical delays were measured with tissue Doppler echocardiography. Both Pmax and PWD were higher in patients with MAC compared with controls (111.4 +/- 15.8 vs 97.3 +/- 18.8 milliseconds; P < .0001 and 46.4 +/- 14.6 vs 31.4 +/- 13.1 milliseconds; P < .0001, respectively). Both interatial and intraatrial conduction time were also delayed in patients with MAC compared with controls (29.8 +/- 13.3 vs 17.6 +/- 12.5 milliseconds; P < .0001; 9.4 +/- 5.1 vs 6.8 +/- 4.0 milliseconds; P < .008, respectively). Left atrial (LA) diameter was significantly higher in patients with MAC compared with controls (35.4 +/- 5.0 mm vs 32.3 +/- 4.2 mm; P < .001). The LA diameter correlated significantly with both interatrial conduction times and PWD (r = 0.56; P < .0001 and r = 0.47; P < .0001, respectively). There is a delay in both intraatrial and interatrial electromechanical coupling intervals in patients with MAC. (C) 2010 Elsevier Inc. All rights reserved.Öğe Assessment of left atrial volume and function by real time three-dimensional echocardiography in obese patients(Wiley, 2017) Yagmur, Julide; Cansel, Mehmet; Kurtoglu, Ertugrul; Hidayet, Siho; Acikgoz, Nusret; Ermis, Necip; Ozyalin, FatmaObjective: To evaluate left atrial (LA) volume and functions in obese subjects using real time three-dimensional echocardiography (RT3DE) and also the relationship between LA mechanical functions and N-terminal pro-atrial natriuretic peptide (NT-proANP). Methods: This study included 40 obese (26 females and 14 males, mean age 51.9 years) and 40 normal weight subjects (23 females and 16 males, mean age 53.5 years) with normal coronary angiograms. All the study participants underwent RT3DE to assess LA volume and mechanical function. Plasma NT-proANP was determined by ELISA method. Results: There was no significant difference between groups in left ventricular (LV) diameters and ejection fraction, which reflect LV systolic function. However, transmitral deceleration time, isovolumetric relaxation time, and peak late diastolic tissue Doppler velocity values, which reflect LV diastolic function, were found to be significantly higher in obese subjects when compared with controls. LA maximum volume (LAVmax), LAVmax index (LAVI), LA minimal volume (LAVmin), before atrial contraction volume (LAVpreA), LA active emptying volume, LA total emptying volume, and LA active emptying fraction, which reflect LA reservoir and pump functions, were also higher in obese subjects when compared with controls. LA passive emptying fraction was significantly lower in obese subjects than in controls. NT-proANP levels were similar between groups. There were positive correlations between NT-proANP level and LAVI, LAVmax, LAVmin, LAVpreA, and LA total and active emptying volumes. Conclusions: Left atrial mechanical functions and volumes are impaired in obese subjects. These findings may be regarded as early markers of subclinical cardiac failure in obese subjects who have not yet exhibited any clinical evidence of cardiovascular disease.Öğe Assessment of left ventricular volume and functions by real-time three-dimensional echocardiography in patients with compensated and decompensated heart failure(Turkish Soc Cardiology, 2012) Akturk, Erdal; Kurtoglu, Ertugrul; Ermis, Necip; Yagmur, Julide; Acikgoz, Nusret; Karakus, Yasin; Pekdemir, HasanObjectives: The aim of the study was to evaluate congestive heart failure (HF) patients with real-time three-dimensional echocardiography (3DE) to investigate why some of them present with acute decompensation despite having two-dimensional echocardiographic (2DE) parameters with compensated HF patients. Study design:The study population consisted of 36 patients with decompensated HF (24 males, 12 females; mean age 65.8 10.4 years) and 30 patients with compensated HF (21 males, 9 females; mean age 63.2 +/- 11.5 years).The levels of pro-brain natriuretic peptide (pro-BNP), serum electrolytes, renal function tests and complete blood counts were determined. All patients underwent 2DE and 3DE evaluations. Results: Heart rate and blood urea nitrogen levels were higher in patients with decompensated HF than those with compensated HF (95.8 +/- 21.4 vs, 81.2 +/- 14.9, p=0.002; 28.3 +/- 15.7 mg/di vs. 18 +/- 6.8 mg/di, p=0.001, respectively). Pro-BNP levels and NYHA class were significantly higher in patients with decompensated heart failure [4925 pg/ml (2199-8711) vs. 330 pg/ml (197-756), p<0.0001 and 2.3 +/- 0.6 vs. 1.2 +/- 0.4, p<0.0001, respectively]. Although 2DE parameters were similar between groups, left ventricular ejection fraction was lower in patients with decompensated HF while end-diastolic and end -systolic volumes by 3DE were significantly higher in the same group (26.3 +/- 3.8% vs, 30.3 +/- 4.0%; 205.6 +/- 55.5 ml vs. 145.0 +/- 33.7 ml; 178.4 +/- 55.6 ml vs. 115.7 +/- 32.5 ml, all p<0.0001, respectively). However, systolic volume was higher in patients with compensated HF (52.0 +/- 15.5 ml vs. 62 +/- 12 ml, p=0.005). Conclusion: We think that 3DE provides more reliable information about left ventricular volume and functions in the evaluation of patients with HF.Öğe Assessment of the left ventricular systolic function in cardiac syndrome X using speckle tracking echocardiography(Turkish Soc Cardiology, 2016) Yagmur, Julide; Acikgoz, Nusret; Cansel, Mehmet; Ermis, Necip; Karakus, Yasin; Kurtoglu, ErtugrulObjective: The aim of this study was to evaluate left ventricular (LV) systolic strain by speckle tracking echocardiography (STE) and real-time three-dimensional echocardiography (3-DE) for the early detection of myocardial dysfunction in patients with cardiac syndrome X (CSX). Methods: We compared 34 patients with CSX (18 females, mean age 47.9 +/- 10.0 years) with 41 healthy persons as a control group (23 females, mean age 50.6 +/- 9.9 years). Inclusion criteria for CSX were typical angina, a positive exercise ECG stress test, and angiographically documented normal coronary arteries. Exclusion criteria for both groups were hypertension, valvular heart disease, cardiomyopathies, inflammatory diseases, myocarditis, vasculitis, arthropathies, Tietze's syndrome, gastrointestinal diseases, aortic diseases, hormone replacement therapy, arrhythmias, liver diseases, and alcohol use. All subjects underwent two-dimensional STE and 3-DE to assess resting LV function. STE measures were taken from the basal septum, mid-septum, apical septum, apex, apicolateral, mid-lateral, basal lateral, anteroseptal, anterior, anterolateral, inferolateral, inferior, and inferoseptal walls. Student's t-test, Mann-Whitney U test, and chi-square test were used to statistically analyze data. Results: LV echo ejection fraction (EF) and systolic wave peak velocity were similar for both groups. Regional mean longitudinal strain (-17.7 +/- 2.5% vs. -19.8 +/- 1.8%; p<0.0001) was significantly lower in patients with CSX than in healthy control patients. However, regional mean circumferential strain values (-22.0 +/- 1.6% vs. -22.2 +/- 2.3%; p=0.78) did not differ significantly between the two groups. Conclusion: Significant impairment of LV longitudinal myocardial systolic function was detected with STE in patients with CSX, although normal 3-D EF and tissue Doppler imaging systolic parameters were observed. Arteriosclerosis of small coronary arteries and microvascular dysfunction may affect myocardial longitudinal strain.Öğe Comparision of pain levels of transradial versus transfemoral coronary catheterization: a prospective and randomized study(Aves, 2014) Akturk, Erdal; Kurtoglu, Ertugrul; Ermis, Necip; Acikgoz, Nusret; Yagmur, Julide; Altuntas, Mehmet Sait; Pekdemir, HasanObjective: The aim of the present study was to assess access site pain levels of patients undergoing coronary catheterization via transradial route. Methods: We performed a prospective and randomized study in which 408 patients underwent coronary angiography (CAG) and/or percutaneous coronary intervention (PCI) via transradial approach (TRA) and 428 patients underwent CAG and/or PCI via transfemoral approach (TFA). Pain levels of patients were assessed with Visual Analog Scale (VAS) after catheterization and at 30 days. Student-t, Mann-Whitney U and chi-square tests were used for statistical analysis. Results: Patients in the TRA group showed higher VAS scores than those in TFA group after catheterization [CAG alone, 3 (2-5) vs. 1 (1-3), p<0.0001; PCI, 4 (2-6) vs. 2 (1-3), p<0.0001, respectively]. One month later, patients in TRA group also showed higher VAS scores than those in TFA group [CAG alone, 1 (0-1) vs. 0 (0-1), p<0.0001; PCI, 1 (0-2) vs. 0 (0-1), p<0.0001, respectively]. By the ROC analysis in TRA group, a level of BMI < 24.3 kg/m(2) predicted unacceptable pain with a 87.3% sensitivity and 91.6% specificity [area under curve (AUC): 0.875, 95% CI: 0.839-0.906, p<0.0001], while a wrist circumference <16.7 cm predicted unacceptable pain with 84.6% sensitivity and 89.8% specificity (AUC: 0.900, 95% CI: 0.867-0.928, p<0.0001). Conclusion: The current study suggests that a radial approach for CAG and PCI in patients with a low BMI and small wrist circumference may cause more access site pain as compared with a femoral approach.Öğe Comparison of echocardiographic parameters of amputee football players with active football players and sedentary individuals(Bmc, 2023) Kurtoglu, Ahmet; Kurtoglu, Ertugrul; Konar, Nurettin; Car, Bekir; Eken, Ozgur; Prieto-Gonzalez, Pablo; Nobari, HadiBackgroundThe purpose of this study is to compare the echocardiographic (ECHO) parameters of amputee football players (AF) with those of athletes without a disability (football players) (FP), and sedentary individuals (SI).MethodsA total of 37 male participants (nAF = 12, nFP = 12, nSI = 13) were included in the study. All participants underwent a transthoracic echocardiographic examination. Aortic diameter in systole (ADs), aortic diameter in diastole (ADd), isovolumic contraction time (IVCT), isovolumic relaxation time (IVRT), left ventricular ejection fraction (LVEF), early (E) and late (A) wave velocities, myocardial systolic (S), early diastolic (E'), and late diastolic (A') myocardial rates, interventricular septal thickness (IVS), left ventricular end-diastolic diameter (LVDd) and left ventricular end-systole diameter (LVDs), left ventricular posterior wall thickness (LVPWd), left atrial diameter (LAD), and ascending aortic diameter (AAD) were measured.ResultsLVDd, E' were lower in AF than in FP. In contrast, LVDs, LVPWd, and A wave were higher in AF than in FP. When AF and SI groups were compared, ADs, LVPWd, A wave, IVRT, and S wave were higher in AF than in SI. ANOVA test showed a statistically significant difference between groups in LVPWd, A-wave, and E' wave. TTE data indicate that some parameters in AF differ from those observed in healthy individuals. The smaller LVEED diameter and higher PWT were found in AF.ConclusionsAlthough within normal limits, some ECHO parameters in the AF group differed from those without disability. Future studies should further investigate these differences using different and detailed measurement methods.Öğe Early Left Atrial Mechanics and Volume Abnormalities in Subjects with Prehypertension: A Real Time Three-Dimensional Echocardiography Study(Wiley, 2012) Akturk, Erdal; Ermis, Necip; Yagmur, Julide; Acikgoz, Nusret; Kurtoglu, Ertugrul; Cansel, Mehmet; Eyupkoca, FerhatThe aim of this study was to evaluate left atrial (LA) volume and mechanical functions by real time three-dimensional echocardiography (RT3DE) in prehypertensive subjects. The study included 54 (34 male and 20 female) prehypertensive subjects and 36 (14 male and 22 female) healthy control subjects. Transthoracic echocardiography and RT3DE were performed in all patients. Interventricular septum thickness and isovolumetric relaxation time were significantly higher in prehypertensives than in controls (10.7 +/- 0.7 vs. 10.1 +/- 0.8 P = 0.001 and 89.9 +/- 10 vs. 82.4 +/- 11 P = 0.002, respectively). LA maximum volume, volume before atrial contraction, total and active stroke volume, total and active emptying fractions, expansion index, and LA max volume index were significantly higher in prehypertensives when compared with controls (P < 0.0001 for all). However, the passive emptying fraction was significantly lower in prehypertensives than controls (45.7 +/- 5.6 vs. 48.6 +/- 4.1, P = 0.006), and the minimum LA volume between the two groups was similar. The main finding of this study was that although LA volume and LA active systolic functions were significantly increased in prehypertensive people, there was a reduction in passive LA systolic functions. These parameters may be important in showing hemodynamic and structural changes in cardiac tissue caused by prehypertension. (Echocardiography 2012;29:1211-1217)Öğe Early single clinical experience with the new Figulla ASD Occluder for transcatheter closure of atrial septal defect in adults(Elsevier Masson, 2011) Cansel, Mehmet; Pekdemir, Hasan; Yagmur, Julide; Tasolar, Hakan; Ermis, Necip; Kurtoglu, Ertugrul; Acikgoz, NusretBackground. Recently, the Occlutech Figulla ASD Occluder (FSO) has been introduced for transcatheter closure of atrial septal defects. This device can be used for transcatheter closure of small as well as large atrial septal defects. Aims. To evaluate the feasibility and short-term results of transcatheter closure of secundum type atrial septal defects using the FSO device in adult patients. Methods. Seventy-four consecutive adult patients were referred for transcatheter closure of secundum large atrial septal defects (stretched diameter > 20 mm and/or invasive pulmonary/systemic flow [Qp/Qs] ratio > 1.5) using the FSO device. Results. The FSO device was successfully implanted in 68 patients (mean +/- SD [range] age: 31.8 +/- 12.3 [17-64] years; weight: 71.5 +/- 18.4 [49-98] kg). All patients had right atrial and ventricular volume overload with a mean Qp/Qs ratio of 2.5 +/- 0.6 (range 1.5-3.8). Mean atrial septal defect diameter was 22.3 +/- 4.8 (range 12-33) mm and the size of the implanted FSO was 24.1 +/- 4.9 (range 12-36) mm. Two patients had trivial (jet width <1 mm in diameter) residual shunts and one patient had a small (1-2 mm) residual shunt. There were no moderate or severe residual shunts. No device embolization or other serious complication occurred during either the procedure or the follow-up. Conclusion. The present study found that transcatheter closure of isolated secundum atrial septal defects using the novel design of the FSO device was safe, effective, and had an excellent outcome during the 6 month follow-up period. (C) 2011 Elsevier Masson SAS. All rights reserved.Öğe Effect of Hemodynamic Changes During Percutaneous Mitral Balloon Valvuloplasty on Short and Long Term Clinical Outcome(Drunpp-Sarajevo, 2012) Akurk, Erdal; Kurtoglu, Ertugrul; Eyupkoca, Ferhat; Ermis, Necip; Acikgoz, Nusret; Yagmur, Julide; Cansel, MehmetAims: We aim of this study is to determine whether hemodynamic changes that occur before and after percutaneous mitral balloon valvuloplasty (PMV) procedure is a predictor in determining the short- and long-term clinical results in patients with mitral stenosis (MS). Methods: The study population consisted of 118 (26 males and 92 females) consecutive patients with symptomatic rheumatic MS, underwent successful PMV. Mean pulmonary artery pressure, pulmonary capillary wedge pressure (PCWP), mean transmitral gradient and mean left atrial was obtained before and immediately after valvuloplasty. Two separate groups were formed on the basis of these measured pressure differences. The first group pressure differences (PD) <= 15 mmHg and the second group PD > 15 mmHg. Results: There was no difference in immediate outcomes between two group. There was no significant difference in between groups in terms of primary endpoints. However, there was a difference in mean left atrial pressure difference (LAPD) between <= 15 mmHg group and > 15mmHg group. MVR and redo PMV rates were significantly lower in LAPD> 15mmHg group (p=0.027 and p=0.03, respectively), the difference between stroke and death rates was not statistically significant (p=0.6). Conclusion: The significant risk factors in determining long-term outcomes in patients undergoing PMV are; mitral valve morphology, atrial fibrillation, advanced age, NYHA class, post-PMV, MR grade, post-PMV MVA, prior surgical commissurotomy, post-PMV pulmonary artery pressure and echocardiographic score. In addition to these parameters we found that LAPD could also be a predictor of long term outcomes patients undergoing PMV.Öğe Elevated Monocyte to High-Density Lipoprotein Cholesterol Ratio and Endothelial Dysfunction in Behcet Disease(Sage Publications Inc, 2018) Acikgoz, Nusret; Kurtoglu, Ertugrul; Yagmur, Julide; Kapicioglu, Yelda; Cansel, Mehmet; Ermis, NecipBehcet disease (BD) is a multisystemic disorder characterized by endothelial dysfunction and inflammation. Monocyte to high-density lipoprotein cholesterol ratio (MHR) is a recently emerged indicator of inflammation and oxidative stress. Sixty patients with BD and 50 control individuals were included to investigate the relationship between MHR and endothelial dysfunction. Endothelial function was assessed by flow- and nitroglycerin-mediated dilatation technique (FMD and NMD, respectively). Serum high-sensitivity C-reactive protein (hsCRP) levels were measured in all study participants. The MHR and hsCRP levels were significantly higher in patients with active BD than in controls. Brachial artery FMD was significantly lower in patients with active BD than in controls. Brachial artery NMD was similar between groups. There was a strong inverse correlation between MHR and FMD and a strong positive correlation between MHR and serum hsCRP levels. Thus, elevated MHR may be a useful marker reflecting impaired endothelial function and systemic inflammation in patients with BD.Öğe Evaluation of contrast nephropathy in percutaneous treatment of chronic total occlusions(Akademiai Kiado Zrt, 2019) Akturk, Erdal; Askin, Lutfu; Tasolar, Hakan; Kurtoglu, Ertugrul; Turkmen, Serdar; Tanriverdi, Okan; Uzel, Kader ElizBackground: Contrast-induced nephropathy (CIN) is a leading cause of morbidity and mortality in patients undergoing percutaneous coronary intervention (PCI). Chronic total occlusions (CTO) are frequently observed among patients undergoing coronary angiography. Methods: A total of 128 CTO patients were included. Mehran score, lesion characteristics, interventional procedure, serological specimens and devices were recorded. The first group was administered with 1 ml . kg(-1) . h(-1) saline (0.9% NaCl) infusion that started 12 h before the procedure and continued 12 h post procedure as recommended by the guidelines. The second group was administered with saline infusion of 12 ml . kg(-1) . h(-1) only during CTO-PCI procedure, which is called as intensive infusion. Results: CIN development was similar in two groups (four patients in standard hydration group and five patients in intensive hydration group). The amount of saline was significantly higher in the standard group (1,767 +/- 192.2 vs. 1,043.6 +/- 375; p < 0.001). Patients with higher creatinine levels prior to PCI had a higher rate of CIN development after procedure. Interestingly, age, left ventricular ejection fraction, and diabetes mellitus independently predicted CIN. Conclusion: Intensive hydration administration appears to be an effective and cost-effective method in CTO-PCI patients, especially in patients without left ventricular function failure.Öğe Evaluation of electrocardiographic parameters in amputee football players(Frontiers Media Sa, 2023) Kurtoglu, Ahmet; Kurtoglu, Ertugrul; Akguemues, Alkame; Car, Bekir; Eken, Oezguer; Sarbu, Ioan; Ciongradi, Carmen IuliaObjectiveThe present study aimed to compare electrocardiographic (ECG) parameters of amputee football players (AF) with football players without disability (FP) and sedentary individuals without disability (SI). MethodsA total of 32 participants (AF = 9, FP = 11, SI = 12) were included in the study. ECG parameters including P-wave amplitude, P-wave duration, PR interval, QRS duration, RR interval, QT interval, corrected-QT interval (QTc), ST segment duration, Tp-e duration, Tp-e/QT and Tp-e/QTc ratios were assessed in all the study participants by using a 12-lead ECG device. OneWay ANOVA Test was used for statistical analysis. ResultsOf all ECG parameters, P-wave amplitude and QTc were significantly higher in the AF group in comparison to FP and SI groups. QRS duration was found to be lower in the AF group when compared to FP and SI groups. Myocardial repolarization parameters including Tp-e duration, Tp-e/QT and Tp-e/QTc ratios were similar between groups, as were other parameters such as P-wave duration, PR interval, RR interval, QRS duration and QT interval. ConclusionIt was found that some ECG parameters of amputee football players differ from those with non-disabled players and non-disabled sedentary individuals. These different parameters were within normal limits.Öğe Evaluation of Electrocardiographic T-peak to T-end Interval in Subjects with Increased Epicardial Fat Tissue Thickness(Arquivos Brasileiros Cardiologia, 2015) Kaplan, Ozgur; Kurtoglu, Ertugrul; Nar, Gokay; Yasar, Erdogan; Gozubuyuk, Gokhan; Dogan, Cem; Boz, Ahmet UgurBackground: The association between periatrial adiposity and atrial arrhythmias has been shown in previous studies. However, there are not enough available data on the association between epicardial fat tissue (EFT) thickness and parameters of ventricular repolarization. Objective: to evaluate the association of EFT thickness with indices of ventricular repolarization by using T-peak to T-end (Tp-e) interval and Tp-e/QT ratio. Methods: The present study included 50 patients whose EFT thickness >= 9 mm (group 1) and 40 control subjects with EFT thickness < 9 mm (group 2). Transthoracic echocardiographic examination was performed in all participants. QT parameters, Tp-e intervals and Tp-e/QT ratio were measured from the 12-lead electrocardiogram. Results: QTd (41.1 +/- 2.5 vs 38.6 +/- 3.2, p < 0.001) and corrected QTd (46.7 +/- 4.7 vs 43.7 +/- 4, p = 0.002) were significantly higher in group 1 when compared to group 2. The Tp-e interval (76.5 +/- 6.3, 70.3 +/- 6.8, p < 0.001), cTp-e interval (83.1 +/- 4.3 vs. 76 +/- 4.9, p < 0.001), Tp-e/QT (0.20 +/- 0.02 vs. 0.2 +/- 0.02, p < 0.001) and Tp-e/QTc ratios (0.2 +/- 0.01 vs. 0.18 +/- 0.01, p < 0.001) were increased in group 1 in comparison to group 2. Significant positive correlations were found between EFT thickness and Tp-e interval (r = 0.548, p < 0.001), cTp-e interval (r = 0.259, p = 0.01), and Tp-e/QT (r = 0.662, p < 0.001) and Tp-e/QTc ratios (r = 0.560, p < 0.001). Conclusion: The present study shows that Tp-e and cTp-e interval, Tp-e/QT and Tp-e/QTc ratios were increased in subjects with increased EFT, which may suggest an increased risk of ventricular arrhythmia.Öğe The impact of metabolic syndrome on left ventricular function: Evaluated by using the index of myocardial performance(Elsevier Ireland Ltd, 2009) Turhan, Hasan; Yasar, Ayse Saatci; Yagmur, Julide; Kurtoglu, Ertugrul; Yetkin, ErtanAim: To evaluate the impact of metabolic syndrome on global left ventricular function by using the index of myocardial performance. Methods: The study population included 106 patients with metabolic syndrome (66 male, 40 female, mean age=54 +/- 11 years) and 106 control subjects without metabolic syndrome (71 male, 35 female, mean age=53 +/- 10). The diagnosis of metabolic syndrome was based on The National Cholesterol Education Program Adult Treatment Panel III criteria. All patients underwent two-dimensional and Doppler echocardiographic examination. The index of myocardial performance was determined as the sum of isovolumic relaxation time and isovolumic contraction time divided by left ventricular ejection time. Results: The index of myocardial performance was found to be significantly higher in patients with metabolic syndrome compared with control subjects without metabolic syndrome (0.55 +/- 0.06 vs 0.38 +/- 0.04 respectively, p < 0.001). Conclusion: In the present study, we have shown the presence of impaired global left ventricular function in patients with metabolic syndrome compared with control subjects without metabolic syndrome. This finding emphasizes the importance of early diagnosis and management of metabolic syndrome to prevent the progression of ventricular dysfunction to overt structural and symptomatic cardiac disease. (C) 2008 Published by Elsevier Ireland Ltd.Öğe Increased Mean Platelet Volume in Behcet's Disease with Thrombotic Tendency(Tohoku Univ Medical Press, 2010) Acikgoz, Nusret; Karincaoglu, Yelda; Ermis, Necip; Yagmur, Juelide; Atas, Halil; Kurtoglu, Ertugrul; Cansel, MehmetThe relationship between Behcet's disease (BD) and platelet aggregation has not sufficiently been investigated yet. Mean platelet volume (MPV) is a marker of platelet function, and the increase in MPV has been identified as an independent risk factor of recurrent vascular events. BD is characterized by a relapsing vasculitis of the venous as well as arterial thrombosis. However, the precise pathogenic mechanisms underlying thrombotic tendency in BD are not known. We hypothesized that there might be an association between thrombotic complication and MPV in these patients. Therefore, we investigated activation of platelets in patients with BD using a simple marker, MPV, the most accurate measure of platelet size. A total of 60 patients with BD and 40 age- and gender-matched controls were included. The BD patients were divided into subgroups based on the presence (n = 22) or absence of thrombosis (n = 38) and clinically active (n = 30) or inactive (n = 30) state. MPV was higher in patients with BD than controls (8.14 +/- 0.8 vs. 7.48 +/- 0.3 fl, p = 0.001). Among BD patients, MPV was larger in patients with thrombosis than those without thrombosis (8.45 +/- 1.0 vs. 7.96 +/- 0.7 fl, p = 0.038). However, there was no significant difference in MPV between BD patients with active and inactive states. The increase in MPV is independent of the disease activity, and the presence of thrombosis is associated with higher MPV in BD patients. Therefore, antiplatelet therapy may be useful to prevent thrombotic complications in BD patients.Öğe Investigation of left atrial mechanical function and left ventricular systolic and diastolic parameters in athletes performing resistance exercise and combined exercise(Bmc, 2024) Kurtoglu, Ahmet; Akguemues, Alkame; Balun, Ahmet; Aydin, Engin; Kurtoglu, Ertugrul; Car, Bekir; Konar, NurettinSome individuals who go to fitness centers for various purposes perform resistance exercise (RE) alone, while others engage in combined exercise (CE) by including cardio exercises along with RE. Studying the effects of these two different training methods on left ventricular (LV) systolic and diastolic parameters and left atrial mechanical function is an important step toward understanding the effects of different types of exercise on cardiac function. This knowledge has significant implications for public health, as it can inform the development of targeted and effective exercise programs that prioritize cardiovascular health and reduce the risk of adverse outcomes. Therefore, the primary aim of this study is to comprehensively investigate the LV systolic and diastolic parameters of athletes who engage in RE and CE using ECHO, to contribute to the growing body of literature on the cardiovascular effects of different types of exercise. Forty-two amateur athletes aged between 17 and 52 were included in our study. The participants consisted of the RE (n = 26) group who did only resistance exercise during the weekly exercise period, and the CE group (n = 16) who also did cardio exercise with resistance exercises. After determining sports age (year), weekly exercise frequency (day), and training volume (min) in addition to demographic information of RE and CE groups, left ventricular systolic and diastolic parameters and left atrial functions were determined by ECHO. Findings from our study revealed that parameters including the left ventricular end-diastolic diameter (LVEDD) (p = .008), left ventricular end-diastolic volume (LVEDV) (p = .020), stroke volume index (SV-I) (p = .048), conduit volume (CV-I) (p = .001), and aortic strain (AS) (p = .017) were notably higher in the RE group compared to the CE group. Also left atrial active emptying vol & uuml;me (LAAEV) of CE was higher than the RE group (p = .031). In conclusion, the cardiac parameters of the RE group showed more athlete's heart characteristics than the CE group. These results may help to optimize the cardiovascular benefits of exercise routines while minimizing the potential risks associated with improper training.Öğe Left atrial volume and function in patients with Behcet's disease assessed by real-time three-dimensional echocardiography(Oxford Univ Press, 2012) Akturk, Erdal; Yagmur, Julide; Kurtoglu, Ertugrul; Ermis, Necip; Acikgoz, Nusret; Sener, Serpil; Karakus, YasinAims Behcet's disease (BD), a multisystemic inflammatory disorder, has been associated with a number of cardiovascular dysfunctions, including endomyocardial fibrosis of the right heart, atrial fibrillation, ventricular arrhythmias and sudden cardiac death. The incidence and nature of cardiac involvement in BD are not yet clearly documented. Our aim was to evaluate left atrial (LA) volume and functions using real-time three-dimensional echocardiography (RT3DE) in Behcet's patients without any cardiac symptom. Methods end results The study included 40 BD (16 females, 24 males and mean age of 33 +/- 7 years) and 30 healthy (11 females, 19 males and mean age of 35 +/- 6 years) subjects. All the patients' demographic parameters such as age, gender, and duration of BD were recorded. All the individuals underwent comprehensive 2D echocardiography examination, and RT3DE was performed to assess LA volumes and mechanical functions. LA maximum volume (V-max) and before atrial contraction volume (V, re A) LA active stroke volume and total stroke volumes (TSV), total emptying and active emptying fractions and expansion index were significantly higher in Behcet's disease patients when compared with the controls (P < 0.0001 for all). LA passive emptying fraction was significantly lower in the patients with BD than in the controls (41 +/- 7 vs. 44 +/- 5, P = 0.039). There were positive correlations between TSV and high-sensitive C-reactive protein level (r = 0.413, P = 0.008), TSV, and disease duration (r = 0.417, P < 0.007). Conclusion Our study has shown that LA mechanical functions and volumes are impaired in BD. These results may be an early form of subclinical cardiac involvement in patients with BD who have no clinical evidence for cardiovascular disease.Öğe Left atrial volume and function in patients with cardiac syndrome X assessed by real time three-dimensional echocardiography(Wiley, 2017) Acikgoz, Nusret; Yagmur, Julide; Kurtoglu, Ertugrul; Ermis, Necip; Cansel, MehmetObjectiveThe aim of this study was to evaluate left atrial (LA) volume and function using real time three-dimensional echocardiography (RT3DE) in patients with cardiac syndrome X (CSX). MethodsFifty patients with CSX (28 females; mean age 50.910.9years) and 50 age- and gender-matched healthy controls (30 females; mean age 52.39.8years) who had negative treadmill exercise test and normal coronary arteries on invasive coronary angiography were included in the study. Comprehensive two-dimensional (2D), pulsed and tissue Doppler, speckle tracking echocardiography, and RT3DE for the assessment of LA dynamics were performed in all study participants. ResultsCardiac syndrome X and control groups have similar clinical characteristics regarding age, sex, body mass index, hypertension, diabetes, and smoking habit. 2D echocardiographic parameters were also similar between groups. Pulsed- and tissue Doppler parameters, IVRT, A, and A(m) values, were higher in CSX group, while E-m, E/A, and E-m/A(m) ratios were higher in the control group reflecting mild diastolic dysfunction. Regarding RT3DE parameters, LA maximum volume, minimum volume, volume before atrial contraction, LA maximum volume index, total and active stroke volumes were found to be increased in CSX patients. However, LA total stroke fraction, passive stroke volume, passive stroke fraction, peak systolic, and diastolic longitudinal strains were found to be lower in CSX patients. ConclusionThe main finding of this study was that CSX patients had altered LA booster pump, reservoir, and conduit functions. This finding may have clinical implications for early detection of abnormal LA dynamics in CSX patients.Öğe The normalized spectral and nonlinear indexes in heart rate variability analysis(Wiley, 2024) Kurtoglu, Ertugrul[Abstract Not Available]
